Procedure scheduled Titan vs AMS

[Dondada]

I did my preop blood work today because I have finally decided to make the leap to "Bionic" status after suffering from venous leakage for many years. Cialis/Viagra worked initially but then stopped; Trimix hurt like hell, and Bimix was mostly ineffective. Last year, when I was planning to go through with the procedure, I was firmly committed to the Titan. However, after catching up on these boards over the past year, I have changed my mind. With the new AMS Tenacio pump available (and with the pump apparently being hard to get use to for many) , concerns about the dog ear issue with the Titan, the AMS being seemingly more comfortable in the flaccid state, and apparently having a lower failure and revision rate, I am now leaning strongly toward the AMS.
I made a mold of my erect girth (see image) to have an accurate before and after so that I won't have to guess.
I have a couple of questions for those of you in the know:

1. I currently have a 5.1 inch girth when erect with an 8-inch bone pressed stretched length. With a cock ring, I can achieve a 6-inch girth. Will the AMS prevent me from realizing that potential, assuming that the cock ring size is actually possible with regular and consistent cycling?

2. I am trying to avoid RTEs (rear tip extenders). Is there something specific I can mention to the doctor in hopes of avoiding them?

3. Based on your experiences, what size implant am I likely to get?

I am consulting with Dr. Bhavik Shah, but Dr. Marc Greenstein will actually perform the procedure due to scheduling conflicts. It is a Coloplast Center of Excellence in Atlanta, GA, so I trust they will do right by me.
Thanks in advance for the feedback and insight.

[Jage64]

RTEs aren't some terrible thing you should avoid.

The point at which the tubes exit the cylinders is fixed, the depth of your crus is not known until the surgery. The surgeon can use the RTEs to move the fixed exit point of the tubes more distally if that's a better point at which the tubes should drop into your scrotum.

Every man's anatomy is different, the RTEs allow the surgeon to custom fit implants that are made to fit most. Stacking too many RTEs could be an issue, as that could mean that the surgeon did not have the proper sized implant on hand so they used RTEs to make up for the wrong size, but any reputable surgeon would not ever do that.

My girth is 5 3/4" and I would not consider my pre or post op penis size as particularly girthy. I don't think you will have any problem being at least at your 5.1" pre-op girth, but the amount of additional swelling you may get due to arousal is not something you can know beforehand. I personally would not use a cock ring with my implant, and I'm not even sure it would do anything for me if I did. Much of my ED issue was leakage, something a cock ring (unless extremely tight) didn't help with much.

Not even the surgeon knows what size implant you'll get until they measure you on the table. There's no way to know what space you have inside you to accommodate the implant, but with a reputable surgeon you can rest assured they'll give you the largest implant safe to install.

Keep in mind what the alternative is to getting the implant....usually the alternative is a miserable sex life, depression and constant frustration. So if the choices are misery and frustration, or a penis that *may be* a little shorter and *may be* a little less girthy, but will never, ever, ever let you down...what would you choose?

Expectation management is a huge part of getting an implant and being happy with it.

*there are those that report a longer and girthier penis than what they had naturally.

[JohnHC]

Like he said, RTE's aren't bad unless you have multiple ones stacked together. They're used mainly to adjust how the tubing drops into the scrotum so that there is less likelihood of the tubing kinking which is not a good thing. Your Dr and the implant rep will make the right decisions during the surgery for the estimate outcome in your case.

[jwdetails]

Like he said, RTE's aren't bad unless you have multiple ones stacked together. They're used mainly to adjust how the tubing drops into the scrotum so that there is less likelihood of the tubing kinking which is not a good thing. Your Dr and the implant rep will make the right decisions during the surgery for the estimate outcome in your case.

agree - i think it depends on how skilled your doctor is at the time of surgery.

An important thing pointed out to me is that the Coloplast has inflatable implants up to 28 cm (including a 5 cm firm base) = 23 cm of true inflatable. The AMS goes to 24 cm (including like 2 cm firm base) = 22 cm inflatable. Based on your measurements and how big your scrotum is to get the pump in a deep spot, you may need RTE if you go with AMS. Agree that stacking them is not ideal - I've been told that for the bigger implants with coloplast you have to custom size the pump tubing so can avoid RTE (still remember that 5 cm is essentially like an RTE on coloplast since its firm and not inflatable). Not sure with the AMS??